TC-99M HEXAMETHYLPROPYLENEAMINE-OXIME LABELED LEUKOCYTE SCINTIGRAPHY IN INFLAMMATORY BOWEL-DISEASE IN CHILDREN

Technetium Tc 99m-labeled hexamethyl-propyleneamine-oxime (Tc-HMPAO) s cintigraphy has been evaluated in adults with inflammatory bowel disea ses and has shown promising ability to define intensity and extent of disease. To evaluate the method's utility in children, we studied 27 p ediatric patients-23 with inflammatory bowel diseases and 4 control su bjects without abdominal inflammation. Autologous leukocytes labeled w ith Tc-HMPAO were reinjected into each patient and serial scans were o btained up to 4 hours later, None of the control subjects had any upta ke of Tc-HMPAO by the bowel. Disease localization as defined by the sc an correlated well with that visualized in surgical specimens from fiv e patients, at endoscopy in three patients, with barium studies of two patients, and with computed tomography scanning of the abdomen in one patient. A ''scan score'' was calculated by comparing uptake of trace r in five bowel segments with iliac crest bone marrow activity. Scan s core correlated much better with clinical disease activity (correlatio n coefficient = 0.62) than did the erythrocyte sedimentation rate (cor relation coefficient = 0.24). Scintigraphy with Tc-HMPAO appears to be useful in evaluation of disease localization and intensity in childre n with inflammatory bower disease.